Please complete:

• information at the top of this form (please remember student last name
  especially if it is different from yours),

• select the applicable Area of Service,

• complete the number of hours, and

• submit (this will send an email message directly to the school)

NOTE: This form will send an automatic email. Depending on the settings of YOUR email program, it may not send the information. You should be able to look in your sent folder and view the information you submitted. You will also receive a reply from the school within a few days confirming receipt. If you have any difficulty in submitting, you may choose to submit a simple email, with the needed information to: pchs@peninsulacatholic.com

Date of Service (MM/DD/YY):
Parent Name: Last  First
Student Name: Last  First

Areas of Service:

Knights of Columbus Bingo - contact Francine Gagne, ext 13 -- Floor Worker Concessions
Number of Hours:
Floor Workers must be a member or spouse of a member of Council 5480 of the Knights of Columbus
Concessions open to anyone

Office of Development - contact Francine Gagne, ext 13 -- Annual Giving Committee Foundations & Grant Writing Committee Major Gifts Committee Marketing Committee Endowment Dinner Committee (end Aug-begin Oct)
Number of Hours:

School Ministry - contact Eleanor Murphy, ext 11  -- Assist with Student Retreats Assist with Community Service
Number of Hours:  

Home and School Association - contact Gwyn Caison, H & S President at 596-7247 -- After-Prom Committee Baccalaureate Committee Graduation Committee Hospitality Committee Lights of Faith/Pasta Night Committee Ways and Means/Fundraising Committee
Number of Hours:
All parents are invited to attend the monthly meetings and get involved in current activities; meetings are held the first
Wednesday of each month at 6:30 PM
*Homeroom Representatives are required to attend monthly meetings

Athletic Department - contact John Jackowski, ext 19 -- Concessions Tickets Clock/Scoreboard Keepers
Number of Hours:

Substitute Teacher - contact Rebecca Henle, ext 23 (type in class taught)
Number of Hours:
Candidate Volunteer:

• Must view Blood-borne Pathogen Presentation
• Must provide negative TB result within three months of starting date
• Must complete "Virginia Dept. of Social Services/Child Protection Services Request for Search of the Central Registry and Release of Information" Form and background investigation
• Comply with applicable provisions of the Diocesan Policy of the Prevention of Sexual Misconduct and/or Child Abuse
• Read the Faculty and Staff Handbook

• Read the Parent/Student Handbook

Other:
Number of Hours: